Food Safety from Farm to Fork to Physician: Moving Towards a One Health Approach: Tuesday, March 4th

In this week's session, Barbara Kowalcyk, Ph.D. and CEO of the Center for Foodborne Illness Research and Prevention (CFI), a national non-profit organization that prevent foodborne disease by advancing a stronger, science-based food safety system, was our honored guest at the North Carolina One Health Intellectual Exchange Group. She received her master's degree in Applied Statistics from the University of Pittsburgh and a Doctorates in Environmental Health with a focus in Epidemiology and Bio-statistics from the University of Cincinnati. Although she began her career as a Statistician at a pharmaceutical company, her passion shifted to foodborne illnesses and food safety, due to a tragic personal event. Since then, her research has focused on the microbial aspect of foodborne pathogens and a system to improve epidemiology surveillance and awareness to prevent a pandemic outbreak.

Dr. Kowalcyk began her discussion by describing food safety and food security along with reasons why it should be a main priority and concern in people's lives. Statistics show approximately 48 million people contract illnesses, 128 thousand are hospitalized and 3 thousand deaths occur globally due to foodborne pathogens. The numbers are so high and increasing from the high transmission rate through food, people, water systems and petting zoos. The most vulnerable populations are pregnant women, senior citizens and children. Dr. Kowalcyk emphasizes the concerns of the under-analyzed effects of foodborne diseases globally, which inhibits the improvements of surveillance. Pathogens, including Norovirus, Salmonella, and E. coli 0157:H7, are continually evolving into new strains of antibiotic resistance that will cause a public health crisis in the 21st century.

Food companies, or the 'producers', have recently been the blame for the spread of foodborne illnesses instead on the consumers. Due to concerns of the spread of these pathogens, they have caused the CDC to implement sterilization procedures, like irradiation (a simple disinfecting process from a  UV light to kill the microbes growing in the food) and systematic preventive programs, like FoodNet, PulseNet, and Hazard Analysis Critical Control Point (HCCP), to food processing companies. Also, in 2011, Congress enacted the Food Safety Modernization Act (FSMA), a food safety law to mandate new risk-based approaches to the FDA's oversight of foodborne illness. This law will ensure the quality and amount of detection of bacteria to monitor the spread around the country. Fortunately, over the years, there has been an increasing amount of attention to improve the surveillance of foodborne diseases and to attempt to prevent sporadic outbreaks from occurring.

Dr. Kowalcyk then further argued the issues of people's assumption that foodborne diseases only result in acute illnesses, such as a 'tummy ache,’ as well as “it's something minor that is not necessary to visit or report to a physician.” In her paper, she describes the many long-term effects to numerous organ systems that people are unaware about the effects. Prominent sequelae of these infections include effects to the gastrointestinal, immune, nervous, respiratory, cardiovascular, endocrine and hepatic systems. Profuse diarrhea, another condition caused by foodborne infections, in children can cause deficits in cognition and development while in adults will make it more chronic [1]. The long-term consequences from the foodborne infections are detrimental to human health and must be taken with precaution. Dr. Kowalcyk wants to educate the people through CFI and provide a source of information about these pathogens, so that it is not something to be under-evaluated. 

Looking ahead towards the future, promising technology and procedures are being tested and formulated to eliminate the outbreaks of infections. An increase of epidemiology will drive preventive actions through the ability to constantly identify and detect the cluster of diseases that significantly harm people around the world. Dr. Kowalcyk quotes "surveillance goes beyond the detection of disease, but it is critical for prevention. There needs to be a surveillance shift from reactive to proactive action." The rise of antibiotic resistant pathogens and the continual difficulty of tracking the origin of the pathogens will force companies, farmers, and other countries to integrate to more cost effective surveillance protocols. Ultimately, the mission to prevent the spread of foodborne diseases is to advocate the necessity of funding for more studies and surveillance techniques to wealthy companies or governments as well as to educate the consumers on safe sterilization that will clean the foods from the burden of these pathogens. Lastly, Dr. Kowalcyk ends her discussion with a slide of children that have died or have severe complications of their lifestyle due to foodborne illnesses as a reminder of the true reason to promote proper surveillance and prevention of foodborne diseases.

[1] Batz, M. B., Henke, E., & Kowalcyk, B. (2013). Foodborne illness: Latest threats and emerging issues. Infectious Disease Clinics of North America, 27, 599-616.

Authored by Thanh-thao Thi Le